Discrimination can increase cancer risk for LGBTQ+ people, says study

Homophobia or transphobia can indirectly increase the chances of queer people developing cancer and worsen health outcomes for those who do, a new study has revealed.

The American Cancer Society’s (ACS) 2024 Cancer Facts and Figures report, published in January, found that “minority stress” experienced by queer people in the face of the discrimination they often face can lead to an prevalence of dangerous behaviours – such as smoking and alcohol abuse – that increase the risk of cancer. 

The report underlined that queer people are more likely to drink alcohol excessively, and, after adjusting for other factors, lesbian and gay people are 27 per cent more likely to smoke cigarettes than straight people, which the study described as a “maladaptive coping mechanism”.

Bisexual individuals are 66 per cent more likely to smoke, and trans people – mainly transgender women – are more likely than cisgender individuals to smoke.

The research also showed that lesbian, gay and bisexual youth, in grades six to 12, are more likely to smoke cigarettes than heterosexual youngsters (four per cent compared with just one per cent).

Minority stress, or the physical stress responses triggered by factors such as discrimination and prejudice can also affect people on a “cellular level”, the report went on to say. 

“Psychological stress influences biochemical changes such as increased cortisol levels, which can lead to chronic inflammation that increases the risk of cancer and other diseases,” according to the study.

It added that those who experience greater minority stress, such as queer people of colour, or disabled queer people, are “more likely to express gene mutations that are functionally related to cancer” and to have side effects from cancer treatment. 

The American Cancer Society Cancer Facts & Figures 2024 report is here. With breast, prostate, colorectal (ages 0-54), and cervical (ages 30-44) cancers on the rise, it’s important to get screened. Hear more from @AmerCancerCEO.
Full report: https://t.co/uvqeomlJSv pic.twitter.com/7GoBOLH80X

— American Cancer Society (@AmericanCancer) January 17, 2024

The report, which explored rates of cancers in all people and encouraged Americans to get screened for the disease, also found that discrimination within healthcare settings can prevent LGBTQ+ people from seeking medical help.

More than half of LGBTQ+ adults have “experienced harassment, including slurs, micro-aggressions, sexual harassment, and violence” in healthcare settings, with incidents of discrimination “most common among people of colour”, the report noted.

On average, one in every six LGBTQ+ adults – one in five when it came to transgender adults – said they avoid healthcare settings as a consequence of this discrimination.

“Insufficient access to high-quality care, limited provider knowledge of LGBTQ+ patient needs, discrimination in the healthcare setting and a lack of population-based cancer-occurrence data are all barriers to health equity that need to be addressed,” the report’s authors urged.

Today, the @AmericanCancer Society released our 2024 Cancer Facts and Figures report. The data reveal that over 2 million NEW cancer cases are expected to be diagnosed in the U.S. These findings underscore the importance of cancer prevention & screening. https://t.co/yhay7OFcFL pic.twitter.com/cTODcPfE1a

— Karen Knudsen, MBA PhD (@AmerCancerCEO) January 17, 2024

To make matters worse, many LGBTQ+ people fear being rejected by healthcare providers because of their sexuality or gender identity, with nine US states, including Arkansas, Florida and Ohio, making it legal for medical professionals to refuse care to queer patients.

These barriers can “lead to poor outcomes” whereby trans people with cancer are more likely to be diagnosed at a more-advanced stage, less likely to receive treatment, and have poorer survival statistics for some cancer types compared to cisgender people, the study revealed.

These outcomes are not limited to the US, with a 2021 report finding that one in seven British trans people have been refused healthcare by their GP because of their gender identity. 

“Transphobia impacts all aspects of daily life for trans people, from relationships with our friends and families, to healthcare, and even listening to the radio,” Jane Fae, the chairperson of Trans Media Watch, said at the time. 

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